Obstetric Anaesthesia

Liverpool Women’s Hospital

Dr Carol Kenyon (carol.kenyon1@lwh.nhs.uk)

Module Details:

Liverpool Women’s Hospital is the regional tertiary unit and is the area’s only stand-alone maternity unit. We have a busy delivery suite with 3 dedicated obstetric theatres and a dedicated obstetric recovery room. The delivery suite contains a number of obstetric HDU rooms. We also have a busy midwife led unit, post-natal wards, and elective LSCS admissions lounge. We very much work as a team alongside our obstetric, midwifery, and theatre colleagues. You will find a friendly and supportive atmosphere in the delivery suite. During this module trainees have the opportunity to complete Advanced Obstetrics as well as the modules below. We also provide opportunity for trainees to develop across 6 domains; teamworking, leadership, innovation, management, education and clinical practice. Doing advanced training in our department provides trainees with the skills and experience required to work effectively and take a leadership role as part of a busy multi-disciplinary specialist team. All the clinical and non-clinical skills developed during time spent in this department provide a sound foundation for anaesthesia across all fields. As well as the areas listed above you will develop important skills in acute pain management, maternal critical care, multidisciplinary teaching, audit, quality improvement and research. We provide acute response, resuscitation and critical care across the trust in clinical and non-clinical areas. We provide lead services for the transfer of critically ill patients to other trusts. All of this provides an excellent learning opportunity for the development of independent practice. If you are interested in spending advanced training at LWH please come and discuss this with the department. We are a small and friendly department, and are all very approachable. Our commitment to your training is that we will provide an educational agreement and environment that allows you to achieve your objectives and develop your CV for consultant application.

Trainee Feedback:

Lots of clinical work and chance to supervise junior trainees. Projects carried out and poster presentations produced.

Whiston Hospital

Dr Catherine Gerrard (catherine.gerrard@sthk.nhs.uk)

Module Details: The Maternity Unit at Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, is a busy Maternity Unit with approximately 4000 deliveries per year. There is an on-demand epidural service with a rate of approximately 24%. Over 90% of elective caesarean sections are carried out under Regional Anaesthesia, as are a large and increasing proportion of emergency caesarean sections. During this Advanced Obstetric Anaesthesia module, Advanced Trainees will provide perioperative anaesthetic care to a wide-range of complex obstetric cases, both on the Labour Ward and in Theatres. This care may be provided directly by the Advanced Trainee or provided by the more junior Anaesthetic Trainees, being supervised by the Advanced Obstetric Anaesthesia Trainee (in a “step-up to Consultant” role, with appropriate supervision). Advanced Obstetric Anaesthesia Trainees will review patients in Obstetric Anaesthetic Clinics. These clinics will include cases requiring pre-operative clinic assessments and also cases requiring pre-operative / post-operative anaesthetic counselling. There will also be the opportunity to observe Obstetric Maternal Medicine Clinics. Advanced Obstetric Trainees are encouraged to teach on the regular local multidisciplinary PROMPT courses, and also to facilitate Obstetric Anaesthesia teaching sessions (including Simulation teaching sessions) for more junior Anaesthetic Trainees. There will also be opportunities to provide teaching to less experienced colleagues of all grades. Recent Audit and QI Projects have been related to the Royal College of Anaesthetists’ Anaesthesia Clinical Services Accreditation (ACSA) criteria. Current projects include the review and streamlining of the Obstetric Anaesthesia follow-up pathways, to ensure that all Obstetric patients receive appropriate follow-up reviews after Epidurals, Spinals and General Anaesthesia. This Advanced Obstetric Anaesthesia Module will also provide Trainees with exposure to areas of clinical management and leadership within the NHS, e.g. through attendance at local governance meetings / the Labour Ward Forum Meetings. Completion of this Advanced Obstetric Anaesthesia module at Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, will not only provide Trainees with Advanced Obstetric Anaesthesia skills, but will also provide them with opportunities to prepare for a successful future career, as a Consultant Anaesthetist.

Arrowe Park Hospital

Dr Alice Arch (alicearch@nhs.net) Module Details: The Maternity Unit at Arrowe Park Hospital has a delivery rate of over 3000 deliveries per year. Due to our co-location with Tertiary Neonatal Services, Adult Critical Care and Adult Acute Care including General and Urological Surgery, Interventional Radiology, Cardiology and Acute General Medicine we have a wide range of presentations of patients who plan to deliver, or are transferred into our unit and therefore are able to offer experience of a wide range of clinical presentations. We have a team of Enhanced Maternity Care (EMC) midwives who are trained to deliver care to patients who require care in our Obstetric HDU rooms and work closely alongside the Obstetric and Anaesthetic teams. Trainees completing their SIA in Obstetric Anaesthesia would be working alongside and within the multidisciplinary team and supervising more junior colleagues. They would have the opportunity to attend Obstetric Anaesthetic Assessment Clinics and to observe Obstetric Clinics. We have a very strong multidisciplinary work ethos and the trainee undertaking an SIA would be supported to delivery teaching as part of the in-house PROMPT teaching, be involved in teaching of the EMC midwifery team and, in discussion with the midwives on our elective Caesarean Section Lotus midwives to facilitate learning for this group. Senior trainees are also encouraged to be actively involved in delivering teaching to the Core Trainees and there are ample opportunities to be involved in delivering Simulation Training. There is the opportunity to develop leadership and management skills through attending Divisional Clinical Governance Meetings, Labour Ward Steering Group, multidisciplinary Maternity Clinical Incident reviews and departmental management opportunities in discussion with the Anaesthetic Department more widely. As an Anaesthesia Clinical Services Accreditation (ACSA) accredited department we encourage trainees to undertake Quality Improvement and Audit projects and as a research active department we are able to support Senior Trainees to participate in Clinical Research. We are open to suggestions as to projects which are of interest and there is a Research Midwife within the Maternity Services who may be able to help with NIHR projects. We aim to offer trainees a breadth of experience to develop their ability to enhance their own career and to prepare for their future role as a Consultant Anaesthetist.